The objectives of this project are: 1) to provide a high quality sickle cell service program (including public education, detection, counseling and comprehensive clinical care) in order to assist each individual with sickle cell anemia to attain a high quality of life despite his/her handicap; 2) to educate and train health care professionals, paraprofessionals and lay persons to provide comprehensive health care to individuals with sickle cell anemia so that manpower factors will not continue to comprise the care of individuals with sickle cell anemia, and 3) to carry out research in sickle cell anemia. The research will be conducted in three general areas: 1) service program research; 2) clinical research on patients with sickle cell anemia; and 3) basis research on the sickling process. In order to accomplish these goals, we will continue to utilize the existing facilities and programs of five relevant institutions, Wayne State University, The University of Michigan, Grace Hospital, The Children's Hospital of Michigan and the Sickle Cell Detection and Information Program, Inc., and the facilities of an additional institution, The University of Detroit.